HOXA11在人子宫内膜和早孕蜕膜中的表达及与不育的关系

Expression of HOXA 11 in human endometrium and decidua and its relationship with unexplained infertility

目的检测HOXA11蛋白在正常月经周期子宫内膜、早孕蜕膜和不明原因不育子宫内膜组织中的表达,探讨HOXA11与不明原因不育及雌孕激素受体(ER、PR)表达的相关性。方法采用免疫组织化学和Western-Blot方法对38例正常子宫内膜、15例早孕蜕膜和19例不明原因不育子宫内膜组织中HOXA11、ER及PR的表达。结果HOXA11蛋白在子宫内膜腺上皮和基质细胞均有表达,以分泌中晚期子宫内膜和早孕蜕膜表达量较高;在不育内膜的表达量显著降低(P<0.05);ER、PR在各组表达量的变化与HOXA11相同,即分泌中晚期子宫内膜和早孕蜕膜的表达量较高,而在不育内膜的表达量显著下降(P<0.05)。结论HOXA11基因在着床期子宫内膜的分化、发育以及着床后妊娠的维持起一定作用;HOXA11表达量下降与ER、PR表达量降低相关;HOXA11表达下降或缺失可能是女性不明原因不育的原因之一。

Objective： To examine the expression of HOXA11, ER and PR in the normal endometrium, decidua of early pregnancy, and the endometrium of unexplained infertility. Methods： The samples were collected from 38 normal cyclic women, 15 women in early pregnancy and 19 women with unexplained infertility. Immunohistochemistry and Western-Blot were applied to analyze the expression levels of HOXA11, ER and PR. Results： HOXA11 was expressed in both glandular epithelial cells and stromal cells of endometrium and decidua. The levels of expression were maximal in the mid- to late-secretory endometrium and decidua. The expression pattern of ER and PR was similar to that of HOXA11 in endometrium during the menstrual cycle and decidua. Expressions of HOXA11, ER and PR in the endometrium of women with unexplained infertility were significantly lower than those in normal mid-secretory endometrium and decidua （P〈0.05）. Conclusions： HOXA11 plays a role in the proliferation and differentiation of the endometrium during menstrual cycle, and may be involved in implantation and decidualization of endometrium during early pregnancy. The down-regulated expression of HOXA11 in the endometrium of the women with unexplained infertility is closely related to the decrease of ER and PR expression, which may be one of the reasons for female infertility.